Active NPI
Benjamin Ramon Lara, LMSW
- Social Worker
- Boise, ID
National Provider Identifier
1063846764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 32322
- Practice address
- 9196 W Barnes Dr
Boise, ID 83709-1552 - Phone
- (208) 433-0400
- Fax
- (208) 433-5271
- NPI assigned
- Aug 29, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 32322 | ID | Primary |
Addresses
Primary practice location
9196 W Barnes Dr
Boise, ID 83709-1552
Mailing address
5859 Millwright Ave
Garden City, ID 83714-1665
Phone (208) 433-0400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32322 | ID | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377734400000",
"number": "1063846764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5859 MILLWRIGHT AVE",
"city": "GARDEN CITY",
"state": "ID",
"postal_code": "837141665",
"telephone_number": "208-433-0400",
"fax_number": "208-433-5271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9196 W BARNES DR",
"city": "BOISE",
"state": "ID",
"postal_code": "837091552",
"telephone_number": "208-433-0400",
"fax_number": "208-433-5271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARA",
"first_name": "BENJAMIN",
"middle_name": "RAMON",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-29",
"last_updated": "2013-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "32322",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.